Health and Economic History: Lessons from the Study of Famines, Epidemics and Colonial Development in British India, 1871-19201 Kohei Wakimura Introduction The period from the beginning of the 1870s to the end of the 1910s can be called ‘the Age of Famines and Epidemics’ in British India. The population growth rate was very low (0.37%) due to many mortality crises such as famines and epidemics. But after the beginning of the 1920s the population growth rate rose above the 1% level (Table 1). According to the nationalist interpretation of the post-independence historiography on famines and epidemics, this situation was caused by colonial exploitation and the concomitant agricultural stagnation. Heavy land revenue, forced commercialization of agriculture, the tendency toward monoculture, and the loss of land by peasants led to the amplified damage of famines and epidemics. But does this description explain the reality? If we look at this period using recent studies, we find in the 1871-1920 period ‘growth’ rather than ‘stagnation’. During this period, the real burden of land revenue was being lessened, commercialization of agriculture did not lead to the decline of food production, and the process of losing land by peasantry did not occur so. Thus, the nationalist interpretation is not successful in explaining the economic historical process. Why did famines and epidemics occur so often, leaving huge casualties? Were famines and epidemics only natural disasters? Or were these phenomena related to the economic historical process? By introducing the ‘health’ factor into the analysis of the economic historical process in British India during the period, this paper will try to 1 This paper is based on my Japanese book, Kikin, Ekibyo, Shokuminchi Touchi (Famines, Epidemics and Colonial Rule: Development and Diseases in British India), Nagoya, 2002. 1 answer these questions. Firstly, my methodological standpoint will be briefly elucidated. Next we will touch upon the debate about the Indian economy during the 1871-1921 period. Then we will present our hypothesis on the low population growth rate during the period. Finally we will take a case study of malaria and population change in Bengal during the 1871-1931 period. 1 How Should We Examine ‘Health’ in Economic History? The main aim of the discipline ‘economic history’ has been measuring commodities or incomes. Economic history has aimed at investigating the process of economic development, that is, whether or not a society has achieved economic progress. The degree of economic development has generally been measured by quantitative changes in commodities or incomes. While quantitative changes in food production is used as a measure of economic development in the case of agricultural societies, multiple measures, including industrial production and service production, are used in the case of industrial societies. In any case the measures can be reduced to commodities or incomes. We can ask what the main interest should be in economic history. If we think that the main interest of economic history should be examining the changing nature of human well being, examining quantitative changes of commodities or incomes should not be the ultimate aim. We cannot deny, of course, that quantitative increases of commodities or incomes are one of the most important determinants of human well being. However, increasing commodities or incomes is not an aim, but a step to an aim. Health is the basic component of human well being. How we can physically act or not is the most important component of human well- being. Therefore it is not unnatural that we set health on the stage of 2 economic history. It is needless to say that the condition of health varies from person to person. But we put the group aspect of health in question. For example, if there were some people who experienced damage to their health, we can think that their human well-being was reduced. Amartya Sen has devised a new concept that more properly expresses human well being.2 His ‘capability’ concept means the space in which human well-being can be measured. His definition is: ‘The life of a person can be seen as a sequence of things the person does, or state of being he or she achieves, and these constitute a collection of “functionings” ― doings and beings the person achieves. “Capability” refers to the alternative combinations of functionings from which a person can choose’.3 There are many functionings, from elementary ones like ‘being adequately nourished’ to very complex ones like ‘being able to take part in the life of the community’. Being healthy or avoiding disease is one of the most elementary functionings. Economics has generally assumed ‘commodities’ or ‘utility’ as the space for measuring human well-being. ‘Commodities’ have been used as the space by economics because they are easy to measure. On the other hand ‘utility’ has been used theoretically, following the utilitarian tradition of economics. Look at the following three stages (Figure 1). A person gets ‘commodities’, then consumes them and attains some ‘functionings’, and finally (mentally) feels ‘utilities’. The implication of the ‘capability’ approach is to measure human well-being in the middle stage. The ‘commodity’ approach has taken precedence because of its easy measurability in economic terms. In contrast, ‘capability’ is not easy to measure, and has been taken out of consideration. But equating the acquisition of commodities with the attainment of functionings is incorrect. 2 Amartya Sen, Inequality Re-examined, Oxford, 1992. 3 Jean Drèze and A. Sen, India: Economic Development and Social Opportunity, Oxford, 1995, p.10. 3 For example, suppose that there are two persons who earn equal incomes. While Mr. A is in good health, Mr. B suffers from a disease. Even though they receive equal incomes, they are not equal in terms of functionings. Or, suppose that there are two societies whose populations produce the same per capita GDP on average. But if there is a significant difference in public health conditions or disease environment between the two societies, there will be a substantial differential in human well-being in terms of functionings. Getting commodities does not automatically mean achieving functionings. Thus, we should take into account other factors if we assess human well being in the space of capability. 2 The Indian Economy 1871- 1920 (1) Nationalist and Revisionist How have ‘the Age of Famines and Epidemics’ been described? We now examine the nationalist view, taking an example from Sumit Sarkar’s work.4 1. Drain of Wealth: Indian wealth was squeezed through land revenue and other means, and then drained off to England, leaving no surplus in India. 2. Commercialization of Agriculture: Although the commercialization of agriculture was driven by railway construction and the resulting growth in exports, it was a ‘forced’ process. Peasants were forced to produce commercial crops in order to pay heavy land revenues or rents. The conversion to commercial crops necessarily led to the decrease of food production, worsening the damage of famines. In addition, the commercialization of agriculture intensified the dependence of 4 S. Sarkar, Modern India 1885-1947, Madras, 1983, pp.24-42. 4 peasants on moneylenders, thereby promoting differentiation of the peasantry. 3. Agricultural Production: Big landlords, moneylenders, and rich peasants who gained much from commercialization of agriculture did not invest much in agricultural production, continuing to depend rather on semi-feudal exploitive relationships. Therefore, agricultural production did not increase, leading to outbreaks of destructive famines. According to the nationalist view, famines and epidemics were the necessary results of the economic historical process during the period. But recent studies have presented another interpretation. We now call it the revisionist view. Below, we present the revisionist interpretation, using the works of N. Charlesworth, B.R. Tomlinson, and T. Roy.5 1 After the 1850s, agricultural prices increased faster than the nominal amount of land revenue. Thus the real burden of land revenue was lightened. 2 The commercialization of agriculture was not a forced process, but rather driven by the peasants’ initiatives. Peasants responded to rising agricultural prices caused by railway construction and the resultant export growth. The process of substitution from food crops to commercial crops did not occur on a large scale. There was an increase in agricultural indebtedness, but it did not lead to a substantial increase in transfers of land ownership to moneylenders. 3 Agricultural production gradually increased from the late 19th century to the First World War. After the First World War agricultural production began to stagnate. 5 N. Charlesworth, British Rule and the Indian Economy, 1800-1914, London, 1982, pp.20-28; B.R. Tomlinson, The Economy of Modern India, 1860-1970, Cambridge, 1993, pp.51-67; Tirthankar Roy, The Economic History of India, 1857-1947, New Delhi, 2000, pp.51-113. 5 This interpretation presupposes a picture of the growth of world trade after the 1860s. The transport revolution brought by railways and steamships substantially reduced freight rates, leading to a large increase in low value-added bulk shipments. The opening of the Suez Canal accelerated these processes. The export of cotton, wheat, oilseeds, jute, tea, rice and so on from India substantially increased after the 1870s. This export growth drove the commercialization of agriculture